title: [Endoscopic management of the complications of bariatric surgery. Experience of more than 400 interventions].
abstract: BACKGROUND
  Many patients who undergo bariatric surgery develop postoperative gastrointestinal complications that can require upper gastrointestinal endoscopy.
  
  
  OBJECTIVE
  To prospectively describe the gastrointestinal complications diagnosed by endoscopy after bariatric surgery.
  
  
  METHODS
  We followed up patients undergoing laparoscopic bariatric surgery between January 1998 and December 2006. The following data were recorded: age, sex, body mass index, comorbidity, type and duration of bariatric surgery, clinical presentation of complications, time of presentation, endoscopic treatment and follow-up.
  
  
  RESULTS
  A total of 474 patients underwent surgery (74% women, 26% men) with a mean age of 44±11 years (range, 15-66) and a mean BMI of 47±7 (range, 33-82). The most frequent surgical procedure was Roux-en-Y gastric bypass (90%). We identified 68 complications (14%) requiring upper gastrointestinal endoscopy: anastomotic stenosis (21 cases, 5%), upper gastrointestinal hemorrhage (16 cases, 3.6%), epigastric pain (12 cases, 2.5%), vomiting (7 cases, 1.5%), heartburn (6 cases, 1.3%) and other (6 cases, 1.3%). No prognostic factor for the development of complications requiring postsurgical endoscopy was identified.
  
  
  CONCLUSIONS
  Anastomotic stenosis is the most common complication requiring endoscopic treatment after bariatric surgery. Upper gastrointestinal bleeding in the immediate and late postoperative period can be safely and effectively treated with endoscopic techniques.
authors.affiliation: Unidad de Endoscopia, Servicio de Gastroenterología, ICMDiM, Hospital Clínic, Universidad de Barcelona, IDIBAPS, CIBEREHD, España. mgfernan@clinic.ub.es
authors.forename: Gloria
authors.initials: G
authors.lastname: Fernández-Esparrach
authors.forename: Henry
authors.initials: H
authors.lastname: Córdova
authors.forename: Josep M
authors.initials: JM
authors.lastname: Bordas
authors.forename: Inés
authors.initials: I
authors.lastname: Gómez-Molins
authors.forename: Angels
authors.initials: A
authors.lastname: Ginès
authors.forename: Maria
authors.initials: M
authors.lastname: Pellisé
authors.forename: Oriol
authors.initials: O
authors.lastname: Sendino
authors.forename: Begoña
authors.initials: B
authors.lastname: González-Suárez
authors.forename: Andres
authors.initials: A
authors.lastname: Cárdenas
authors.forename: Domingo
authors.initials: D
authors.lastname: Balderramo
authors.forename: Antonio M
authors.initials: AM
authors.lastname: Lacy
authors.forename: Salvadora
authors.initials: S
authors.lastname: Delgado
authors.forename: Josep
authors.initials: J
authors.lastname: Llach
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000009:adverse effects; D003251:Constriction, Pathologic; D004106:Dilatation; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D006356:Heartburn / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology; D013276:Stomach Ulcer / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D014741:Video Recording; D014839:Vomiting / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D055815:Young Adult